Aims To determine the incidence and risk factors of cystoid macular oedema (CMO) following descemet membrane endothelial keratoplasty (DMEK) with or without combined cataract surgery (triple-DMEK). Methods We reviewed the records of patients who underwent DMEK surgery alone or triple-DMEK performed at the Rothschild Foundation Hospital (Paris, France) between January 2019 and March 2020. Patients with pre-existing CMO observed on the preoperative macular optical coherence tomography (OCT) were excluded. Spectral-domain OCT was performed in patients with postoperative visual impairment. Data regarding comorbidities, intraoperative characteristics and postoperative treatments or complications were collected and analysed. Univariate and multivariate analyses were performed. Results Twenty three of 246 eyes (9.36%) developed clinically significant (cs)-CMO after DMEK. Triple-DMEK was not associated with a higher risk to develop CMO (12.2% in DMEK alone and 6.1% in triple-DMEK). Pseudophakic bullous keratopathy (PBK ; 39.1% vs 9%; OR=3.5 (1.0 to 11.8), p=0.045) and epiretinal membrane (ERM; 39.1% vs 7.7%; OR=10.5 (3.4 to 32.3), p<0.001) were more frequently observed in patients who developed CMO. The occurrence of hyphaema during surgery was statistically associated with postoperative CMO (13% vs 1.3%; OR=7.1 (1.0 to 48.8) p=0.045). Peroperative epithelial debridement was statistically associated with postoperative CMO (65.2% vs 33.2%, p=0.005), but only in univariate analysis. Conclusions We identified a clinically significant CMO incidence of 9.35% after DMEK. Patients with a history of ERM, PBK and intraoperative hyphaema may be at risk of developing CMO after DMEK surgery and should be monitored. No data are available.

中文翻译：

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后弹力膜内皮角膜移植术后黄斑囊样水肿

目的 确定后弹力膜内皮角膜移植术 (DMEK) 联合或不联合白内障手术 (triple-DMEK) 后黄斑囊样水肿 (CMO) 的发生率和危险因素。方法 我们回顾了 2019 年 1 月至 2020 年 3 月期间在罗斯柴尔德基金会医院（法国巴黎）接受单独 DMEK 手术或三联 DMEK 手术的患者的记录。 ) 被排除在外。对术后视力受损的患者进行了光谱域 OCT。收集并分析了有关合并症、术中特征和术后治疗或并发症的数据。进行了单变量和多变量分析。结果 246 只眼中有 23 只眼（9. 36%) 在 DMEK 后发展为具有临床意义的 (cs)-CMO。三重 DMEK 与发生 CMO 的较高风险无关（仅 DMEK 为 12.2%，三重 DMEK 为 6.1%）。假晶状体大疱性角膜病变（PBK；39.1% 对 9%；OR=3.5（1.0 至 11.8），p=0.045）和视网膜前膜（ERM；39.1% 对 7.7%；OR=10.5（3.4 至 32.3），p<0.001）在发生 CMO 的患者中更常见。手术期间前房积液的发生与术后 CMO 有统计学相关性（13% 对 1.3%；OR=7.1（1.0 至 48.8）p=0.045）。围手术期上皮清创与术后 CMO 有统计学相关性（65.2% 对 33.2%，p=0.005），但仅在单变量分析中。结论 我们发现 DMEK 后具有临床意义的 CMO 发生率为 9.35%。有ERM病史的患者，DMEK 手术后 PBK 和术中前房积液可能有发生 CMO 的风险，应予以监测。没有可用数据。